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Kuwait's health ministry said yesterday that an investigation so far hasn't turned up any evidence to suggest that a South Korean business traveler who was diagnosed with MERS-CoV (Middle East respiratory syndrome coronavirus) after returning to his home country was exposed in Kuwait, the Korea Times reported today.
At a media briefing, Mustafa Redha, MD, health ministry undersecretary, said 10 people who had close contact with the South Korean man in Kuwait have tested negative for the virus and the country has taken all steps needed to protect its citizens and visitors from the virus.
Kuwaiti health officials have asked the World Health Organization (WHO) to send a team to confirm its test results, and the Korea Centers for Disease Control and Prevention (KCDC) is slated to send two experts, according to the Times.
According to reports from South Korean health officials, a few days before the man flew back to South Korea he visited a hospital in Kuwait twice for worsening diarrhea. He flew through Dubai on the way to South Korea, and the news report said the man's transfer took less than 3 hours and he had not visited any other country. The incubation period for MERS-CoV is 2 to 14 days.
Kuwait has not reported a MERS case since 2015, but the virus is known to circulate widely in dromedary camels in the Middle East and beyond.
In other developments, no other MERS-CoV cases have been found in South Korea so far following the confirmation of the man's illness on Sep 8. In its latest update today, the KCDC said it is still monitoring 21 close contacts among 431 people identified as contacts.Sep 13 Korea Timesstory
Sep 13 KCDC update (in Korean)

Saudi MOH: Two new MERS cases linked to camel exposure

The Saudi Arabian Ministry of Health (MOH) recorded two new MERS-CoV cases this week, both connected to camel exposure, according to an update today.
A 44-year-old man from Riyadh and a 64-year-old man from Hofuf were both diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus) and are hospitalized for their infections. Both cases are described as primary and linked to camel contact.
Camel contact, both direct and indirect, is one of the known risk factors for MERS transmission.
The new activity appears to have raised MERS case totals to 2,251 globally since 2012, including 798 deaths.MOH epidemiologic week 37 update

CDC: Cyclospora investigation ends with 511 illnesses

Yesterday the US Centers for Disease Control and Prevention (CDC) released its final numbers on a Cyclospora outbreak tied to contaminated McDonald’s salads, noting that 4 more cases had been added to outbreak totals, raising the final tally to 511 illnesses.
Sixteen states reported cases, and 24 people were hospitalized. There were no deaths. Illinois reported the most cases (274), followed by Iowa (99) and Missouri (52). During the investigation into the outbreak, ill people reported buying salads from McDonald's restaurant locations in the Midwest, the CDC said.
Case-patients ranged in age from 14 to 91 years, with a median age of 52. Sixty-six percent of patients were women. "This outbreak appears to be over," the agency said.
On Jul 13, McDonald's voluntarily stopped selling salads in 14 states. On Jul 26, the Food and Drug Administration confirmed that a bagged romaine lettuce and carrot mix from a Fresh Express processor in Streamwood, Ill., was contaminated with Cyclospora.Sep 12 CDC update

Backyard poultry connected to 334 cases of Salmonella

The CDC today also announced the end of an investigation into Salmonella illnesses caused by exposure to backyard poultry flocks.
Officials confirmed 334 illnesses, including 56 hospitalizations, in 47 states since Feb 15 of this year, the CDC said. No deaths were connected to this outbreak, which involved several strains of Salmonella: Seftenberg, Montevideo, Infantis, Enteritidis, Indiana, and Litchfield.
Twenty-one percent of illnesses were reported in children under the age of 5, and 132 (63%) of 211 ill people reported contact with chicks or ducklings in the week before their illness started.
Whole-genome sequencing conducted on 141 isolates from ill people showed that 28 contained genes that predict antibiotic resistance to at least one of the following: ampicillin, streptomycin, sulfamethoxazole, tetracycline, gentamicin, ceftriaxone, amoxicillin-clavulanic acid, cefoxitin, ciprofloxacin, or fosfomycin.
The CDC said hand washing, and supervising children are some commonsense ways to reduce the risk of Salmonella illness from backyard birds.Sep 13 CDC update

Eye exams recommended for all children born during Zika outbreak

A study today in Pediatrics shows that 25.4% of children born to mothers with confirmed or suspected Zika infections during Brazil's 2015-16 outbreak had eye abnormalities. The authors said these findings should prompt universal eye screening for all children born after Zika outbreaks.
In the study, 224 infants born to Brazilian mothers who had symptomatic Zika infections, or infants with microcephaly or other signs of possible Zika infection or exposure, were tested with reverse transcriptase polymerase chain reaction and subsequently given eye examinations in 2016 and 2017.
According to the study, eye abnormalities were found in 57 of 224 infants (25.4%). Optic nerve (44 of 57; 77.2%) and retina abnormalities (37 of 57; 64.9%) were the most common abnormalities reported.
"CNS [central nervous system] abnormalities significantly increased the chances of eye abnormalities in our cohort by 15-fold," the authors wrote. "Nevertheless, we also examined infants who had no apparent clinical findings and were born to mothers with a diagnosis of ZIKV infection during pregnancy. Five infants had eye abnormalities identified in the absence of any CNS findings."
Thus, the authors recommend eye screenings in Zika outbreak settings regardless of the presence of microcephaly, other abnormalities, or laboratory confirmation of infection.Sep 13 Pediatrics study

Rapid cholera spread in Zimbabwe capital triggers stepped-up response

A quickly spreading cholera outbreak in Zimbabwe's capital city of Harare has prompted the WHO to scale up its response, according to a statement today from its Regional Office for Africa.
The outbreak began on Sep 1, and as of Sep 11, 2,000 suspected cases have been reported, 58 of them confirmed and 24 fatal. Zimbabwe's health ministry has declared a state of emergency and is working with its international partners to contain the spread of the disease.
According to the WHO, the outbreak is centered in Glenview, a high-density suburb of Harare that is an active trading center with a highly mobile population. Inadequate supplies of safe water have forced residents to turn to unsafe supplies, such as wells and bore holes. Cases have been reported in 5 of the country's 10 provinces.
Matshidiso Moeti, MD, who directs the WHO's African regional office, said in the statement, "When cholera strikes a major metropolis such as Harare, we need to work fast to stop the spread of the disease before it gets out of control." The WHO is helping the health ministry form a surge team and is providing cholera kits that contain oral rehydration solution, intravenous fluid, and antibiotics to cholera treatment centers.
The government is weighing the benefits of a possible oral cholera vaccine (OCV) campaign, and the WHO is deploying an expert in OCV campaigns to Harare. Zimbabwe experiences frequent cholera outbreaks and reported its largest outbreak in 2008, an event that led to more than 4,000 deaths.
Several African countries are battling cholera outbreaks, including Niger, Cameroon, Algeria, Angola, the Democratic Republic of the Congo, Kenya, Nigeria, and Tanzania.Sep 13 WHO Regional Office for Africa statement

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